Knee implant system

ABSTRACT

Knee prosthesis includes a femoral component adapted to fit on a distal end of the femur and a tibial insert component. The femoral component includes a measured anterior/posterior dimension defined by the posterior condyle surface and the interior surface of the anterior flange and a distal peg provided on a distal bone facing surface of each of the lateral and medial condylar structures, wherein the distal pegs are positioned at a midpoint of the measured anterior/posterior dimension. The implant system provides two distinct sizing segments and the tibial insert has a medial tibial aspect ratio of 0.74 and a lateral tibial aspect ratio of 0.65 to 0.68 for all sizes.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application is a continuation of U.S. patent applicationSer. No. 15/811,537, filed Nov. 13, 2017, now U.S. Pat. No. 10,098,748,which is a continuation of U.S. patent application Ser. No. 15/200,465,filed Jul. 1, 2016, now U.S. Pat. No. 9,814,586, which is a continuationof U.S. patent application Ser. No. 13/840,931, filed Mar. 15, 2013, nowU.S. Pat. No. 9,381,088, which is a continuation of U.S. patentapplication Ser. No. 13/009,158, filed Jan. 19, 2011, now U.S. Pat. No.8,403,944. The disclosures of the foregoing applications areincorporated herein by reference.

FIELD OF THE INVENTION

The present disclosure relates generally to knee prostheses that moreclosely emulate the kinematics of the actual knee joint.

BACKGROUND

Modern total knee arthroplasty implants replace three separatearticulating surfaces within the knee joint: the patello-femoralcompartment and the lateral and medial inferior tibio-femoralcompartments. Most currently available implants for Total KneeReplacement (TKR) are designed to articulate from a position of slighthyperextension to approximately 115° to 130° flexion. A tricompartmentaldesign can meet the needs of most TKR patients even though the healthyhuman knee is capable of a range of motion (ROM) approaching 170°.However, there are some TKR patients who have a particular need toobtain high flexion in the knee joint. For many, a TKR that permitspatients to achieve a ROM in excess of 130° is desirable to allow deepkneeling, squatting and sitting on the floor with the legs tuckedunderneath.

Conventional TKR implants do not produce normal knee kinematics ormotion and generally have a limited range of motion as compared to thatof a normal knee. This is because conventional TKR implants flex byrotating about a generally horizontal axis during flexion and extension,whereas the kinematics of a natural knee joint involves more complexmotion of the femur and tibia relative to one another. For example, in anatural knee, the tibia rotates internally about the longitudinal axisof the tibia during flexion.

Although some attempts have been made to design a total knee prosthesiswhich replicates the kinematics of a natural knee, there exists a roomfor more improvement.

SUMMARY

According to an embodiment of the present disclosure, a knee prosthesisfor replacement of at least a portion of a knee joint in a leg of apatient is disclosed. The knee prosthesis comprises a femoral componentadapted to fit on a distal end of the femur and a tibial insertcomponent adapted to fit on a tibial base component. The femoralcomponent comprises a lateral condylar structure and a medial condylarstructure, the lateral condylar structure defining a lateral condylarsurface and the medial condylar structure defining a medial condylarsurface. The femoral component also includes a measuredanterior/posterior dimension defined by the posterior condyle surfaceand the interior surface of the anterior flange. A distal peg isprovided on a distal bone facing surface of each of the lateral andmedial condylar structures, wherein the distal pegs are positioned at amidpoint of the measured anterior/posterior dimension.

The medial condylar structure of the femoral component can be describedas a spherical surface, extending from the posterior portion of themedial condyle to the anterior portion of the medial condyle. Thelateral condylar structure of the femoral component can be described asovoid, with the posterior portion of the lateral condyle beingspherical, but the anterior portion of the lateral condyle havingdifferent sets of radii in the sagittal (side) and coronal (front)planes.

The tibial insert comprises a lateral bearing surface, a medial bearingsurface, a medial anterior/posterior dimension, a lateralanterior/posterior dimension, and a medial/lateral dimension, whereinthe ratio of the medial anterior/posterior dimension to themedial/lateral dimension is 0.74 and the ratio of the lateralanterior/posterior dimension to the medial/lateral dimension is 0.66 to0.68. The lateral condylar surface of the tibial insert is configured tocontact the lateral bearing surface and the medial condylar surface isconfigured to contact the medial bearing surface when the kneeprosthesis is installed in the leg of a patient.

The knee prosthesis of the present disclosure provides a primary totalknee arthroplasty implant that is stable in the primary areas of gaitwhile permitting the patient to achieve deep flexion (flexion anglesgreater than 120°). The knee prosthesis is stable throughout itsfunctional flexion by providing features that resist paradoxical motionand promote deep flexion.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of an embodiment of a left knee femoralcomponent of a knee prosthesis system of the present disclosure.

FIG. 2 is a top down view of the femoral component of FIG. 1.

FIG. 3 is a side view of the femoral component of FIG. 1.

FIG. 4 is a side view composite illustration of several sizes of thefemoral component shown in FIG. 1.

FIG. 5 is top down view composite illustration of several sizes of thefemoral component shown in FIG. 1.

FIG. 6 is a perspective view of an embodiment of a left knee tibialinsert component of a knee prosthesis system of the present disclosure.

FIG. 7 is a perspective view of another embodiment of a left knee tibialinsert component of a knee prosthesis system of the present disclosure.

FIGS. 8-10 are top down views of the left knee tibial insert componentof FIG. 6.

The features shown in the above referenced drawings are illustratedschematically and are not intended to be drawn to scale nor are theyintended to be shown in precise positional relationship. Like referencenumbers indicate like elements.

DETAILED DESCRIPTION

This description of the exemplary embodiments is intended to be read inconnection with the accompanying drawings, which are to be consideredpart of the entire written description. In the description, relativeterms such as “lower,” “upper,” “horizontal,” “vertical,”, “above,”“below,” “up,” “down,” “top” and “bottom” as well as derivative thereof(e.g., “horizontally,” “downwardly,” “upwardly,” etc.) should beconstrued to refer to the orientation as then described or as shown inthe drawing under discussion. These relative terms are for convenienceof description and do not require that the apparatus be constructed oroperated in a particular orientation. Terms concerning attachments,coupling and the like, such as “connected” and “interconnected,” referto a relationship wherein structures are secured or attached to oneanother either directly or indirectly through intervening structures, aswell as both movable or rigid attachments or relationships, unlessexpressly described otherwise.

FIGS. 1-3 show a femoral component 100 of a knee prosthesis of thepresent disclosure. FIG. 6 shows one embodiment of a tibial insertcomponent 200A of the knee prosthesis. FIG. 7 shows another embodimentof a tibial insert component 200B of the knee prosthesis.

Referring to FIG. 1, the femoral component 100 has a medial condyle 104and a lateral condyle 105 providing medial and lateral condylar surfacesthat cooperate with the corresponding bearing surfaces on the tibialinserts 200A or 200B (shown in FIGS. 6 and 7, respectively). Referringto FIGS. 2 and 3, the femoral component 100 includes a femoralanterior/posterior dimension 114 a that extends from the posteriorcondylar surface 115 of the lateral condyle 105 to the lateral anteriorcondyle surface 116. The femoral component 100 also includes a femoralmeasured anterior/posterior dimension 114 b that extends from theposterior condyle surfaces 115 to the proximal tip 109 of the interiorsurface of the anterior flange 108, which references the anterior cortexof the distal portion of the femur of the patient anatomy.

The femoral component 100 has at least two distal pegs 135, one distalpeg on the bone facing surface 140 of each of the lateral and medialcondylar structures, that are used for medial/lateral stability for thefemoral component 100 when installed on a patient's femur. The femoralcomponent 100 is offered in a variety of sizes with progressivelyincreasing the femoral measured anterior/posterior dimensions 114 b thatwill accommodate the varying dimensions seen in the same measure of thepatient anatomy. The distal pegs 135 are also used for instrumenting theposition of the femoral component on the femur.

However, unlike the femoral components in conventional knee prosthesissystems, in which the various sizes of the femoral components arereferenced either from the anterior cortex surface of the distal portionof the femur or the posterior condyles of the distal portion of thefemur, the various sizes of the femoral component 100 of the kneeprosthesis of the present disclosure are referenced from the midline 130of the measured anterior/posterior dimension 114 b of the femoralimplant component 100. The distal pegs 135, provided on the bone facingsurface 140 of each of the medial and lateral condyles 104, 105 arelocated along the midline 130 of the femoral component 100. The measurefor size for any knee implant system is the measure from the tangentfrom the posterior condyles to the anterior cortex; this is similar tothe femoral measured anterior/posterior dimension 114 b. In the kneeimplant system of the present disclosure, the distal pegs 135 arepositioned at the midpoint of the femoral measured anterior/posteriordimension 114 b.

Thus, the distance from the posterior condyle surface 115 to the midline130 is one-half of the femoral measured anterior/posterior dimension 114b. Therefore, all sizes of the femoral component 100 are referenced fromthe midline 130 represented by the position of the distal pegs 135. Thisis illustrated in FIG. 4 which is a side-view composite illustration ofseveral sizes of the femoral component 100.

As the femoral component 100 reduces in size, both the anterior flange108 and the posterior portions 104 p and 105 p of the condyles getcloser toward the distal pegs 135. This sizing method requires boneresections on both the anterior side and posterior side of the distalend of the patient's femur thus ensuring that new bone surfaces areprovided for interfacing with the femoral component 100 when the surgeondownsizes the femoral component 100 during fitting process.

This is particularly important for cement free implants that requireinterface of cut bone with the bone ingrowth surfaces of the implant andthat gaps are not present at the implant/bone interface. This method ofgrowth from size to size of the present disclosure reduces the amount ofbone removed from either anterior or posterior compartment by half whena smaller size is chosen from this “mid-line” frame of reference.

Conventional knee systems that “grow” their implant from either theanterior side or posterior side only will require that all the bone isremoved from the side opposite from the reference surface whendownsizing of the implant is required. This can be problematic in theconventional referencing systems. An anterior referencing system willhave a tendency to remove posterior condylar bone when downsizing,opening the flexion gap and reducing posterior condylar offset(dimension from tangent of the posterior condyles of the femoral implantto the posterior cortex of the distal femoral bone) which can createinstability and reduce flexion respectively. Conversely, a posteriorreferencing system will have a tendency to either overstuff thepatella-femoral gap if the component is too large or risk notching(resulting in an undercut) the anterior cortex of the distal femoralbone which may reduce flexion or increase the risk of femoral bonefracture respectively.

Each size femoral component 100 has the femoral anterior/posteriordimension 114 a, the femoral measured anterior/posterior dimension 114b, and a femoral medial/lateral dimension 155. The ratio of one measure,the femoral anterior/posterior dimension 114 a to the femoralmedial/lateral dimension 155, is defined as femoral aspect ratio, whichis a measure of distal femoral profile. The ratio of another measure,the femoral measured anterior/posterior dimension 114 b to the femoralmedial/lateral dimension 155, referred to as the measured aspect ratio,is a measure more pertinent to implants as this is the datum referencebetween the posterior condyles and the proximal tip 109 of the interiorsurface of the anterior flange 108, the surface that contacts theanterior cortex of the distal portion of the femur of the patientanatomy.

The knee prosthesis system of the present disclosure comprises twodistinct sizing segments with different femoral aspect ratio ranges. Awider primary size range has a femoral aspect ratio of 0.87 to 0.95 anda narrower stature size range has a femoral aspect ratio range of 0.97to 1.00. The measured aspect ratio, the ratio of the femoral measuredanterior/posterior dimension 114 b to the femoral medial/lateraldimension 155, is also defined by two sizing segments; a wider primarysize range has a femoral aspect ratio range of 0.80 to 0.87 and anarrower stature size range has a femoral aspect ratio range of 0.89 to0.91. This provides significant benefit over the conventional kneesystems where only one size segment is offered for a given measuredanterior/posterior dimension.

The availability of offering two distinct sizing segments for a givenmeasured anterior/posterior dimension 114 b provides the benefit ofoptimizing the fit of the implant for a multitude of patientpopulations. Conventional knee systems that offer only one size segmentfor a given measured anterior/posterior dimension may not accommodateall of the variations seen for a given patient populations and as aresult may deviate from a desired size for a given patient and createpotential complications as a result (i.e. reduced posterior condylaroffset, notching the anterior cortex, etc.). The options offered in thepresent disclosure provide an attempt to reduce these complications fromoccurring by providing the optimal size prosthesis.

Referring to FIG. 5, which is a composite illustration of several sizesof the femoral component 100, each distal femoral implant 100 size alsohas their own femoral medial/lateral dimension 155 and furthermore theirown condylar spacing dimension contained within three groups: C1, C2 andC3. Condylar spacing dimension is the distance between the articulatinghigh points from medial condyle 104 and lateral condyle 105. The kneeprosthesis system of the present disclosure comprises three distinctcondylar spacing ratio ranges, defined by the dimension between medialand lateral condyle apex over the implant medial/lateral dimension 155of the femoral prosthesis 100. The group C1 has a condylar spacingratios in the range of 0.59 to 0.62. The wider sizing segment of groupC2 has a condylar spacing ratios in the range of 0.55 to 0.64. Thenarrower sizing segment of group C2 has a condylar spacing ratios in therange of 0.60 to 0.69. The group C3 has a condylar spacing ratios in therange of 0.60 to 0.63.

Referring to FIGS. 6-10, the tibial inserts 200A and 200B are configuredwith a tissue friendly notch 205 for the patella tendon located at theanterior side of the tibial inserts 200A and 200B. The medial/lateralmidline 200 m notes the neutral position of the component. The notch 205is angled in the direction 205 a of the quadriceps pull. The notch 205helps prevent or relieve potential impingement of the patella tendonduring knee flexion. The tibial inserts 200A and 200B are alsoconfigured with an anterior lip 213 on anterior portion of the medialcompartment 212. This anterior lip 213 provides the structure to preventtranslation of the femoral component 100 during early gait.

The tibial insert embodiment 200A, which is intended to be implantedwith the posterior cruciate ligament (PCL) in place and is provided witha tissue friendly notch 206 for the PCL that is angled in the direction206 a of the PCL pull. The tibial insert embodiment 200B is intended tobe implanted where the PCL has been removed and thus the tissue friendlynotch 206 is not necessary.

Each size tibial insert implants 200A, 200B has a tibial medialanterior/posterior dimension 208, a tibial lateral anterior/posteriordimension 209, and a tibial medial/lateral dimension 215. The kneeimplant system of the present disclosure is characterized by particularratios of these dimensions. The ratio of the tibial medialanterior/posterior dimension 208 to the tibial medial/lateral dimension215 is referred to as the medial tibial aspect ratio and the ratio ofthe tibial lateral anterior/posterior dimension 209 to the tibialmedial/lateral dimension 215 are defined as the lateral tibial aspectratio. These dimensional ranges provide the knee implant system of thepresent disclosure to optimally fit the patient population. The kneeimplant system of the present disclosure has a medial tibial aspectratio of about 0.74 for all sizes and a lateral tibial aspect ratio inthe rage of about 0.65 to 0.68. Additionally, the % difference betweenthe medial anterior/posterior dimension 208 and the lateralanterior/posterior dimension 209 ranges from 9.6% to 13.3%. The %difference is calculated by ((medial anterior/posterior dimension208)−(lateral anterior/posterior dimension 209)/lateralanterior/posterior dimension 209). Conventional knee systems eitherprovide a symmetric implant that will leave portions of the proximaltibial resection uncovered, or are not symmetric enough where patientanatomy trends to become more asymmetric as the knee becomes larger. Theknee implant system of the present disclosure trends to have a moreasymmetric tibial prosthesis for larger tibial implants.

The knee implant system comprising the distal femoral component 100, thetibial insert components 200A and 200B, and the tibial base componentthat the tibial insert components interface with, provides the surgeonwith implants of varying sizing options to enable more accurate fittingto a given patient's anatomic requirements. The knee implant system ofthe present disclosure also provides more natural knee joint kinematicspromoted by the structures described above. For example, the anteriorlip 213 of the tibial insert components 200A, 200B prevent or limit theanterior translation of the femoral component 100 during flexion andpermitting a spinning motion of the medial condyle 104 on the medialcompartment 212 of the tibial insert component 200A and 200B, whilepermitting a rolling motion of the lateral condyle 105 on the lateralcompartment 210 of the tibial insert component 200A and 200B.

Although the invention has been described in terms of exemplaryembodiments, it is not limited thereto. Rather, the appended claimsshould be construed broadly, to include other variants and embodimentsof the invention, which may be made by those skilled in the art withoutdeparting from the scope and range of equivalents of the invention. Thescope of the invention disclosed herein is to be limited only by thefollowing claims.

What is claimed is:
 1. A knee implant system for reducing an amount of bone removed from an anterior and a posterior side of a femur comprising: a plurality of femoral components of various sizes, wherein each of the various sizes of the femoral components is referenced from a midline of a measured anterior/posterior dimension of the femoral implant component, the measured anterior/posterior dimension defined by posterior condyle surfaces and a proximal tip of an interior surface of an anterior flange, such that as the femoral components reduce in size, the proximal tip of the anterior flange and the posterior condyle surfaces get closer toward the midline, and each of said femoral components having a medial condyle having a medial condylar surface, the medial condylar surface being a spherical surface extending from a posterior portion of the medial condyle to an anterior portion of the medial condyle.
 2. The knee implant system of claim 1, wherein for each reduction in femoral component size, the proximal tip of the anterior flange and the posterior condyles get closer toward the midline at an equal rate.
 3. The knee implant system of claim 1, further comprising each of the femoral components having a distal peg on a bone facing surface of each of a lateral and the medial condyle, wherein the distal pegs are positioned on the midline.
 4. The knee implant system of claim 3, wherein the plurality of femoral components comprises two distinct sizing segments with different femoral aspect ratio ranges, the femoral aspect ratio defined as the ratio of the femoral anterior/posterior dimension to the femoral medial/lateral dimension, wherein the femoral anterior/posterior dimension extends from the posterior condylar surface of a lateral condyle to a lateral condylar surface, wherein the two distinct sizing segments with different femoral aspect ratio ranges comprise: a wider primary size range having a femoral aspect ratio of 0.87 to 0.95, and a narrower stature size range having a femoral aspect ratio range of 0.97 to 1.00.
 5. The knee implant system of claim 3, wherein the plurality of femoral components comprises two distinct sizing segments with different measured aspect ratio ranges, the measured aspect ratio defined as the ratio of the femoral measured anterior/posterior dimension to the femoral medial/lateral dimension, wherein the two distinct sizing segments with different measured aspect ranges comprise: a wider primary size range having a femoral aspect ratio range of 0.80 to 0.87 and a narrower stature size range having a femoral aspect ratio range of 0.89 to 0.91.
 6. The knee implant system of claim 3, wherein the femoral components have a femoral aspect ratio of 0.87 to 0.95 and a measured aspect ratio of 0.80 to 0.87, wherein the femoral aspect ratio is the ratio of the femoral anterior/posterior dimension to the femoral medial/lateral dimension and the measured aspect ratio is the ratio of the femoral measured anterior/posterior dimension to the femoral medial/lateral dimension, wherein the femoral anterior/posterior dimension extends from the posterior condylar surface of the lateral condyle to the lateral condylar surface, and the femoral medial/lateral dimension extends from the lateral side of the lateral condyle to the medial side of the medial condyle.
 7. The distal femoral component of claim 6, wherein the femoral components have a condylar spacing ratio of 0.59 to 0.62, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 8. The distal femoral component of claim 6, wherein the femoral components have a condylar spacing ratio of 0.55 to 0.64, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 9. The distal femoral component of claim 6, wherein the femoral components have a condylar spacing ratio of 0.60 to 0.63, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 10. The distal femoral component of claim 6, wherein the femoral components have a condylar spacing ratio of 0.60 to 0.69, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 11. The distal femoral component of claim 3, wherein the femoral components have a femoral aspect ratio of 0.97 to 1.00 and a measured aspect ratio of 0.89 to 0.91, wherein the femoral aspect ratio is the ratio of the femoral anterior/posterior dimension to the femoral medial/lateral dimension and the measured aspect ratio is the ratio of the femoral measured anterior/posterior dimension to the femoral medial/lateral dimension, wherein the femoral anterior/posterior dimension extends from the posterior condylar surface of the lateral condyle to the lateral condylar surface, and the femoral medial/lateral dimension extends from the lateral side of the lateral condyle to the medial side of the medial condyle.
 12. The knee implant system of claim 1, wherein the plurality of femoral components comprises two distinct sizing segments with different femoral aspect ratio ranges, the femoral aspect ratio defined as the ratio of the femoral anterior/posterior dimension to the femoral medial/lateral dimension, wherein the femoral anterior/posterior dimension extends from the posterior condylar surface of a lateral condyle to a lateral condylar surface, wherein the two distinct sizing segments with different femoral aspect ratio ranges comprise: a wider primary size range having a femoral aspect ratio of 0.87 to 0.95, and a narrower stature size range having a femoral aspect ratio range of 0.97 to 1.00.
 13. The knee implant system of claim 1, wherein the plurality of femoral components comprises two distinct sizing segments with different measured aspect ratio ranges, the measured aspect ratio defined as the ratio of the femoral measured anterior/posterior dimension to the femoral medial/lateral dimension, wherein the two distinct sizing segments with different measured aspect ranges comprise: a wider primary size range having a femoral aspect ratio range of 0.80 to 0.87 and a narrower stature size range having a femoral aspect ratio range of 0.89 to 0.91.
 14. The knee implant system of claim 1, wherein the femoral components have a femoral aspect ratio of 0.87 to 0.95 and a measured aspect ratio of 0.80 to 0.87, wherein the femoral aspect ratio is the ratio of the femoral anterior/posterior dimension to the femoral medial/lateral dimension and the measured aspect ratio is the ratio of the femoral measured anterior/posterior dimension to the femoral medial/lateral dimension, wherein the femoral anterior/posterior dimension extends from the posterior condylar surface of the lateral condyle to the lateral condylar surface, and the femoral medial/lateral dimension extends from the lateral side of the lateral condyle to the medial side of the medial condyle.
 15. The distal femoral component of claim 14, wherein the femoral components have a condylar spacing ratio of 0.59 to 0.62, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 16. The distal femoral component of claim 14, wherein the femoral components have a condylar spacing ratio of 0.55 to 0.64, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 17. The distal femoral component of claim 14, wherein the femoral components have a condylar spacing ratio of 0.60 to 0.63, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 18. The distal femoral component of claim 14, wherein the femoral components have a condylar spacing ratio of 0.60 to 0.69, wherein the condylar spacing ratio is the ratio of the dimension between medial and lateral posterior condylar apex to the femoral medial/lateral dimension.
 19. The distal femoral component of claim 1, wherein the femoral components have a femoral aspect ratio of 0.97 to 1.00 and a measured aspect ratio of 0.89 to 0.91, wherein the femoral aspect ratio is the ratio of the femoral anterior/posterior dimension to the femoral medial/lateral dimension and the measured aspect ratio is the ratio of the femoral measured anterior/posterior dimension to the femoral medial/lateral dimension, wherein the femoral anterior/posterior dimension extends from the posterior condylar surface of the lateral condyle to the lateral condylar surface, and the femoral medial/lateral dimension extends from the lateral side of the lateral condyle to the medial side of the medial condyle. 